Clinical application of morning urinary albumin-to-creatinine ratio in assessing proteinuria in patients with chronic kidney disease
LI Hui
LIN Wen-ya
CAI Dong-hao
XIAO Bin
TAN Jun-qing
LI Ai-wen
Abstract：Objective To explore the quantitative relationship between the morning urinary albumin-to-creati-nine ratio(ACR)and 24-hour urine total protein(24 h UTP),and to evaluate the clinical application of ACR in pa-tients with chronic kidney disease(CKD).Methods A total of 169 hospitalized CKD patients from October 2023 to September 2024 were enrolled.Patients were staged according to CKD diagnostic criteria.Morning urine ACR and 24 h UTP were measured and their correlation analyzed.The effects of estimated glomerular filtration rate(eGFR),sex,and age on the correlation were evaluated.Receiver operating characteristic(ROC)curves were used to determine the optimal ACR thresholds corresponding to 24 h UTP levels ≥150 mg,≥ 1 000 mg,and ≥3 500 mg.Results In the overall co-hort,morning ACR was significantly positively correlated with 24 h UTP(r=0.854,P＜0.000 1).Stratified analysis by CKD stage showed consistent positive correlations,with the strongest correlations observed in CKD stages 2 and 3,and moderate correlations in stages 1,4,and 5.Sex and age had no significant effect on the correlation between ACR and 24 h UTP.ROC analysis identified optimal ACR thresholds corresponding to 24 h UTP ≥150 mg,≥1 000 mg,and ≥3 500 mg as 80.14 mg/g,274.15 mg/g,and 1 007.67 mg/g,respectively,with high sensitivity and specificity.Conclusion Morning urinary ACR is a reliable and practical marker for assessing proteinuria in CKD patients,showing superior con-venience and clinical value compared to 24 h UTP measurement.
Keywords：chronic kidney diseasealbumin-to-creatinine ratio24-hour urinary proteincorrelation
Publication Date：2025-09-15
Online Publishing Date：2025-11-06(First online date of this platform, not the publication date of the document)
Pages：5( 1329-1333 )